Journal Article

CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancer

Guha, Avirup, Li, Benjamin, Fradley, Michael, Makari, Doris, Arias, Irene, Moore, Heather, Dent, Susan, McCaleb, Rachael, Stergiopoulos, Stella

2025

Overview

Background Cardiovascular (CV) comorbidities and concurrent medications with risk of heart rate-corrected QT interval (QTc) prolongation can impact treatment decisions and safety discussions for patients with breast cancer. However, limited data are available regarding their prevalence in patients with HR + /HER2– metastatic breast cancer (mBC). We evaluated the prevalence of CV comorbidities, the use of concurrent medications with risk of QTc prolongation, and treatment patterns in patients with newly diagnosed HR + /HER2 − mBC. Methods This retrospective analysis utilized claims data from Merative™ Marketscan® Commercial and Medicare databases. Claims-based algorithms identified patients with newly diagnosed HR + /HER2– mBC between January 2016 and December 2022. The index date was defined as the first date of an mBC claim during this period. For each patient, data on pre-existing CV comorbidities and first-line treatments were captured for 12 months before and 6 months after the index date, respectively. Results A total of 6525 patients with newly diagnosed HR + /HER2 − mBC were identified. At mBC diagnosis, 61.7% of patients had ≥ 1 CV comorbidity. Of patients with CV comorbidities, 22.5% and 30.6% took 1 or ≥ 2 medications, respectively, with risk of QTc prolongation. First-line use of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors increased from 22.1% of patients with CV comorbidities diagnosed in 2016–2017 to 31.5% of those diagnosed in 2018–2022. Conclusions We found that CV comorbidities and use of medications with risk of QTc prolongation were common in patients with newly diagnosed HR + /HER2 − mBC. These factors should inform treatment decision-making (including CDK4/6 inhibitor selection), safety discussions with patients, and CV monitoring. Graphical Abstract

• Publisher: BioMed Central,Springer Nature B.V,BMC
• Subject: Breast cancer / Cancer therapies / Cardiology / Cardiovascular comorbidities / Chemotherapy / Codes / Comorbidity / Cyclin-dependent kinase 4/6 inhibitor / Cyclin-dependent kinases / Decision making / Diabetes / Disease / FDA approval / HR + /HER2 / Kinases / Medical claims / Medicare / Medicine / Medicine & Public Health / Melanoma / Metastasis / Metastatic breast cancer / Mortality / Oncology / Patients / Pharmacy / QTc prolongation